An explorative study of current strategies to reduce sedentary behaviour in hospital wards

Alexandra Mavroeidi, Lianne McInally, Flavio Tomasella, Philippa M. Dall, Dawn A. Skelton

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Abstract

Background: Prolonged sitting (or sedentary behaviour (SB)) has profound detrimental effects on health and is associated with increased risk of chronic disease, hospitalisation and premature death. In clinical practice, one of the principle aims in the rehabilitation of older adults is to maintain or increase physical activity. However while in hospital, a person will spend the vast majority of the day sitting or lying down, often in a single uninterrupted bout. A number of strategies (including the popular twitter-based campaign #endpjparalysis) have started to be implemented in hospital wards to get patients up and moving. Objective: This is the first explorative study that measured objectively the postural SB of older hospitalised adults taking part in such initiatives. Methods: Forty-three people (mean age 83.8y (SD 8.3)) who were admitted at Kello Hospital (NHS Lanarkshire) wore a waterproofed activity monitor (activPAL3) on the front of the thigh for 4days (including overnight); SB was analysed for waking hours (defined as 6:00-23:00), for each day. Interventions designed to get patients up and moving were introduced sequentially (following a service improvement methodology), with each intervention including all elements from former ones. Participants were grouped based on the highest level of intervention they received. Results: There were 4 groups: 'control' (n=12), 'education' (advice of SB reduction via infographics on the ward noticeboards, n=12), '#endpjparalysis', (up and dressed by the nurses before 11:30am, n=9), 'personalised activity care plans' (custom-made advice by OTs on SB reduction, n=10). There were no differences between the groups (ANOVA) for total sitting time (p 0.989), time spent upright (standing and walking) (p 0.700), number of sitting events (i.e. sit to stand transitions) (p 0.418) and longest upright period (p0.915). Discussion/Conclusion: This small explorative study of hospital based patients identified the inability of current initiatives to decrease SB. The cross-sectional nature of the study limited the ability to assess change in individuals as interventions were introduced. Further work iswarranted to untangle the determinants of SB in hospital settings and implement interventions of sustainable SB change in this setting.
Original languageEnglish
Pages (from-to)285-295
Number of pages11
JournalAIMS Medical Science
Volume6
Issue number4
DOIs
Publication statusPublished - 12 Nov 2019

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Keywords

  • sedentary behaviour
  • hospital patients
  • quality improvement
  • explorative study
  • older adults
  • physical inactivity
  • hospitalisation
  • personalised activity passports

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